POS1304 CORRELATION OF SKIN SCORES (LoSCAT) WITH PATIENT REPORTED OUTCOMES IN JUVENILE LOCALISED SCLERODERMA
Authors: C. Pain, A. Murray, G. Dinsdale, A. Marsden, J. Manning, A. Herrick
Journal: Annals of the Rheumatic Diseases (2022)

Background Juvenile localised scleroderma (JLS) or morphea is a rare condition, causing inflammation and fibrosis in skin and underlying tissues. A validated skin score (Localized Scleroderma Cutaneous Assessment Tool, LoSCAT) has been developed [1]. This tool has both activity (mLoSSi) and damage indices (LoSDI). Several patient-reported outcomes (PRO) have been studied in JLS including visual analogue scales (VAS), functional and health-related quality of life measures. Objectives To assess the associations between different PROs and the activity and damage indices of the LoSCAT. Methods Participants aged 4 to 17 were recruited from 3 tertiary paediatric rheumatology centres in the UK and attended 4 visits at 3 monthly intervals as part of a program of research on JLS. Patient-reported VAS (6 different scales), the Children’s Dermatology Life Quality Index (CDLQI) and Childhood Health Assessment Questionnaires (CHAQ) were completed at each visit. LoSCAT was completed by the two same clinicians throughout the study (both trained in skin score techniques). Pearson correlation coefficients were calculated between each PRO and each component of the LoSCAT. Results 24 participants completed all 4 visits and 1 attended 3 visits. 20 participants were female (80%) and 5 were male (20%). Mean age at diagnosis was 7.6 years with mean disease duration of 4.9 years. Subtype of disease was linear head in 5/25 (20%), linear limb 12/25 (48%), generalised morphoea 1/25 (4%), mixed 5/25 (20%) and superficial plaque in 2/25 (8%). Table 1 shows the correlations with figures in bold highlighting positive correlations which were statistically significant (p&lt;0.05) and medium-sized (r&gt;0.3). Table 1. Correlation between patient reported outcomes and LoSCAT PRO Total skin activity (mLoSSi) Total skin damage (LoSDI) r (95% CI) p-value r (95% CI) p-value CDLQI 0.61 (0.02, 1.20 ) 0.044 0.42 (0.01, 0.83 ) 0.044 CHAQ 0.30 (0.03, 0.57 ) 0.027 0.20 (-0.14, 0.54 ) 0.244 VAS 1 : How much IMPACT has your disease had on your life in the PAST MONTH? 0.49 (0.00, 0.98 ) 0.050 0.38 (0.06, 0.71 ) 0.021 VAS 2 : How much has your condition (localized scleroderma) affected you OVERALL in the PAST MONTH? 0.59 (0.09, 1.09 ) 0.022 0.42 (0.13, 0.72 ) 0.005 VAS 3 : Have your lesions felt itchy and/or scratchy in PAST MONTH? 0.40 (-0.01, 0.81) 0.056 0.31 (0.03, 0.59) 0.028 VAS 4 : Have you felt numbness, tingling, and/or other “funny” feeling in or around your lesion in PAST MONTH? 0.55 (0.04, 1.05 ) 0.033 0.33 (-0.04, 0.71) 0.084 VAS 5 : How much WORRY do you have about LONG- -TERM problems from your disease? 0.40 (-0.01, 0.81) 0.053 0.32 (0.00, 0.63 ) 0.047 VAS 6 : How much WORRY do you have about problems from MEDICATIONS used to treat your condition? 0.41 (0.00, 0.82 ) 0.050 0.29 (-0.09, 0.66) 0.131 The VAS of symptoms of numbness/tingling showed a strong positive correlation with mLoSSi but a weak and/or non-significant correlation with LoSDI. VAS itchy/scratchy did not show a strong correlation with mLoSSi but showed a moderate correlation with LoSDI. Patient global VAS correlated with both mLoSSi and LoSDI, as did CDLQI. CHAQ correlated with activity only. Conclusion Symptoms within lesions are often interpreted as indicating disease activity. A previous study in adults and children showed itch positively correlated with mLoSSi suggesting it may be a marker of active disease [2]. However, in our study numbness/tingling correlated with disease activity whereas itch did not. Further work is required to understand whether itch correlates to both activity and damage and whether numbness/tingling is a better indicator of activity than itch. Limitations of our study include a heterogenous group of participants with longstanding high-burden disease. References [1]Arkachaisri et al. Rheumatology 2010. 49(2): 373-81. [2]Klimas et al. Br J Derm 2015; 175:1329-1337 Acknowledgements This study was funded by Scleroderma &amp; Raynaud’s UK. Disclosure of Interests None declared